| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,949.84 | $5,495.41 | $5,495.41 | |
Kaiser Permanente
| Professional | $309.03 | $331.13 | $416.87 | |
United
| Facility | $1,995.26 | $1,995.26 | $1,995.26 |
Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,949.84 | $5,495.41 | $5,495.41 | |
Kaiser Permanente
| Professional | $309.03 | $331.13 | $416.87 | |
United
| Facility | $1,995.26 | $1,995.26 | $1,995.26 |